Matsumura Yuji
Department of Thoracic Surgery, Ohta Nishinouchi Hospital, Kohriyama, Japan.
Kyobu Geka. 2009 Jul;62(8 Suppl):638-42.
Electro-surgical device is an essential instrument for bloodless surgery after the 1st introduction by Harvey Cushing in 1926. Basal mechanisms of electric scalpels (monopolar and bipolar), current waveforms (cut, coagulation and blend), high-frequency currents and electrical shocks were commented. After 1990s, several new electro-surgical devices such as argon beam coagulator, bipolar scissors and vessel sealing system (LigaSure) were developed and introduced in chest surgery. Argon beam coagulator is useful in sealing and hemostasis of bleeding from chest walls after extrapleural dissections. Bipolar scissors can seal small vessels less than diameter 2 mm and is useful in mediastinal lymphnode dissections. Vessel sealing system is able to seal and cut vessels up to diameter 7 mm. LigaSure V is the most suitable instrument for thymic vein handling in thoracoscopic thymectomy. Clinical applications of these new surgical devices in chest surgery are discussed.
1926年哈维·库欣首次引入电外科设备后，它成为了无血手术的重要器械。文中对电刀（单极和双极）的基本机制、电流波形（切割、凝血和混合）、高频电流和电击进行了评论。20世纪90年代后，几种新的电外科设备，如氩束凝血器、双极剪刀和血管封闭系统（LigaSure）被开发出来并应用于胸外科手术。氩束凝血器可用于胸膜外剥离术后胸壁出血的封闭和止血。双极剪刀可封闭直径小于2毫米的小血管，在纵隔淋巴结清扫术中很有用。血管封闭系统能够封闭和切割直径达7毫米的血管。LigaSure V是胸腔镜胸腺切除术中处理胸腺静脉最合适的器械。文中讨论了这些新手术设备在胸外科手术中的临床应用。
